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Association of gout with osteoporotic fractures

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Abstract

Purpose

Previous studies have shown that serum uric acid levels and inflammation are associated with bone mineral density. Gout, a disease characterized by hyperuricemia and inflammation, contributes to the risk of osteoporotic fractures. However, this association is controversial. Therefore, this study investigated whether gout in older people (age > 55 years) is associated with osteoporotic fracture risk.

Methods

This population-based, cross-sectional study included 2674 participants (147 cases of gout and 388 fractures). Standardized and self-administered questionnaires were employed and physical examinations, blood tests, and bone mineral density examinations were performed; multivariate-adjusted logistic regression models were used to evaluate associations between gout and osteoporotic fracture risk.

Results

The data were adjusted for age; smoking status; alcohol status; physical activity; body mass index; waist circumference; hypertension; cardiovascular events; diabetes mellitus; rheumatoid arthritis; serum levels of total cholesterol (TC), triglycerides, and high- and low-density lipids; and T-scores. We found a significant association between gout and osteoporotic fracture risk in women (odds ratio [OR], 2.00; 95% confidence interval [CI], 1.12–3.56; P = 0.019), but no such association in men (OR, 1.30; 95% CI, 0.58–2.88; P = 0.525). Further stratified analyses showed a significant association between gout and osteoporotic fracture risk in women without rheumatic arthritis and in those with high TC levels or with osteoporosis (all, P < 0.05).

Conclusions

In older Chinese adults, gout is significantly associated with the risk of osteoporotic fractures in women, especially those without rheumatic arthritis and in those with high TC levels or with osteoporosis.

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Funding

The project was supported by a grant from the National Natural Science Foundation of China (No. 81572122).

Author information

Author notes

  1. Yanmao Wang and Runhua Zhou contributed equally to this work.

Authors and Affiliations

  1. Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Yishan Rd 600, Shanghai, 200233, People’s Republic of China

    Yanmao Wang, Runhua Zhou, Wanrun Zhong, Chengfang Hu, Shengdi Lu & Yimin Chai

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  1. Yanmao Wang
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  2. Runhua Zhou
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  4. Chengfang Hu
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Contributions

WY, LS, and CY contributed to the study design. WY, ZR, ZW, and HC performed data collection, data interpretation, and data analysis. LS and CY performed critical review. WY, ZR, ZW, HC, LS, and CY performed data collection, case diagnoses, and confirmation of case diagnoses.

Corresponding authors

Correspondence to Shengdi Lu or Yimin Chai.

Ethics declarations

This study was approved by the Ethics Committee of Shanghai Sixth People’s Hospital, and all participants provided informed consent.

Conflict of interest

The authors declare that they have no conflicts of interest.

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Wang, Y., Zhou, R., Zhong, W. et al. Association of gout with osteoporotic fractures. International Orthopaedics (SICOT) 42, 2041–2047 (2018). https://doi.org/10.1007/s00264-018-4033-5

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  • DOI: https://doi.org/10.1007/s00264-018-4033-5

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